心血管疾患と診断

Introduction: Acute coronary syndromes with persistent ST-segment elevation (STEMI) constitute a cardiologic emergency. The objectives of this study were to investigate their epidemiological, diagnostic, therapeutic, prognostic and evolutionary aspects in cardiologic environment in Dakar.

Patients and methods: It was a retrospective study from January 2013 to December 2014 including patients admitted for STEMI in the cardiology unit of the General Hospital of Grand Yoff. The collected data were analyzed and significance level was selected for a value of p<0.05.

Results: We included 114 patients, the prevalence was 10%. The average age was 59.13 ± 13.7 years. The sex ratio (M/F) was 1.85. Cardiovascular risk factors were dominated by sedentary lifestyle (71.93%) and arterial hypertension (54.39%). Chest pain was typical in 69.30% of cases. The average waiting period for admission was 27.60 hours. Electrocardiographic abnormalities mainly concerned anterior (62.28%) and lower (32.46%) territories. Thrombolysis was performed in 52 patients (45.61%) within an average waiting period of 5.32 hours. Four patients underwent coronary angioplasty. Hemodynamic (25.39%) and renal (12.28%) complications were more frequent. The hospital mortality rate was 12.28%. Prognostic factors of death were the state of cardiogenic shock (p=0.001) and acute renal failure (p=0.04).

Conclusion: STEMI are common in Dakar. Long delays in care and the lack of primary angioplasty are responsible for significant morbidity and mortality.